Thinking or Behaving Positively: which is best for depression?
A cornerstone of cognitive behavioral therapy (CBT) is encouraging the person with depression to identify patterns of negative and self-defeating thoughts and replace these with more adaptive thoughts. In treating depression it's really not sufficient to pick one aspect of the human condition and focus energy on it. In other words, simply targeting thought processes in the hope the person will see the lack of logic in the way they think is probably doomed to failure. Even the most rational person does not solemnly take time to pick off their non-adaptive thought processes and replace them. I'm not suggesting Cognitive Therapists do this, in fact the emphasis is usually on thought and behavior, but I have come across situations where patients, for different reasons, focus on an aspect of therapy at the expense of other equally important things.
One way of thinking about depression is the way it affects both thought and actions. The thought processes of someone who is depressed are almost entirely negative, not just about themselves, but the world they live in. Black-and-white thinking is a characteristic, as is a sense of pointlessness, self-blame, and so on. Then again, a number of actions are associated with depression. Withdrawal from social activities, isolation, reduced personal care, disengaging from work or other hobbies and interests, are some examples.
These days a lot of people make use of the internet or self-help material to try and lift their mood. This is fine, there's some good stuff around, but it's easy sometimes to miss the key issues. The moral of this story is that any move towards treating depression has to encompass both thinking and behavior. It's not an either-or option.
Athough thoughts and actions may appear separate, they aren't. Accepting that you have irrational and self-defeating thoughts will not, of itself, lift your depression. It is however a start. What matters is that you coordinate thoughts and actions. Put simply, if you behave more confidently, you will start to feel more confident. Imagine running down a hill; you do this without thinking. But, have you ever run down a hill and actually thought about what you're doing? Chances are you stumble and fall over. Building up a skill until it becomes effortless can take time. So it is with thinking and actions around depression. It's a feedback loop where one thing affects another, and with practice, things get better.